MedicaidAdministrativeMedium impact
Fee-for-service coverage of federally supplied oral antiviral COVID-19 treatments
Oregon Health Plan·OR·Provider
Effective date
Jan 20, 2022
We identified it
Jun 20, 2026
Summary
Oregon Health Authority will now directly reimburse dispensing fees for federally-supplied oral COVID-19 antiviral medications for Oregon Health Plan members, bypassing CCO billing. Billing teams must route these pharmacy claims to OHA instead of the member's CCO for non-Medicare patients.
Action Required
Immediately: For Oregon Health Plan members receiving federally-supplied oral COVID-19 antivirals, billing team must bill OHA directly for non-Medicare members (including CCO enrollees) instead of billing the CCO. Continue billing Medicare plans for Medicare members. Contact Oregon Pharmacy Call Center at 888-202-2126 for point of sale questions.